Take the Blue Poop Challenge
(Header image credit - screenshot from video at https://joinzoe.com/bluepoop)
Do you know your gut-transit time? In layman’s terms, gut-transit time is the amount of time it takes for you to poop after you eat. My gut-transit time is 23.8 hours. Did I surmise this by eating corn or beets? Nope! Instead, I became a citizen scientist and participated in the Zoe Blue Poop challenge.
THE BLUE POOP CHALLENGE
Launched in May of 2021, the Blue Poop challenge is the brainchild of the health science company, Zoe (more about them in the next section). To participate in the challenge, you will eat 2 blue muffins for breakfast, record the time and date you ate, then watch out for blueish/greenish poop, and record the time and date you pooped. Then you head to the Blue Poop challenge website and submit your times and answer a few questions, and you’ll get your results, including what type of POOPER you are. Gut transit time has the potential to reveal information about your gut microbiome - you can learn even more about this by participating in the challenge yourself!
Poo Spoiler Alert, I’m a SUPER POOPER.
BLUE MUFFINS
Mmmmmmm. . . . .
Here’s a shot of my blue muffins!
Baking blue muffins is easy even for a novice baker, and Zoe provides a muffin recipe (it’s naturally vegan!) as well as a list of appropriate food dyes. Regular food coloring won’t be strong enough, so you have to use a deeper more intense coloring, such as soft gel pastes, that are often used in bakeries and home kitchens to create colored icings. (At one point you could also purchase muffin baking kits through the website, but I can no longer find that option so maybe their supplies were exhausted.) Keep in mind that the muffin recipe yields 12 muffins, for a total of 6 servings, so you should enlist your friends to take the challenge with you. I was able to convince three friends to participate - thank you Megan, Stuart, and Dana!
WHAT’S IN THE BOWL?
While the Zoe Blue Poop challenge website says to watch out for “blue-green poop” and they further encourage you to look at your toilet paper for confirmation, it’s not that simple. I actually had to do the experiment twice because the blue-green coloration of my poop was so subtle, thus hard to verify. I heard this same thing from another friend who participated. Honestly, naming it the “Blue Poop Challenge” is, at least based on these two anecdotes, misleading.
And while you are encouraged to post photos of your blue muffins, you are encouraged to NOT post photos of your poop. We are such a strangely prudish culture when it comes to our bodies and their processes. I’d say we are downright detached from the glorious complexities and intricate beauty of our gastrointestinal systems. Imagine a world where participants could have scrolled through fecal photos, showing poops on a continuum of blue/green, from the frustratingly subtle to the possibly vibrant. Just knowing this, even sans photos, would have saved me some time, and toilet paper.
So if you participate in the Blue Poop challenge, don’t just look for blue-green poo, but look for any poo that is subtly colored or jslightly off from your normal coloration. Needless to say, it was deflating to not actually poop blue as I’d been led to believe. I wonder how much blue dye I’d need to ingest to get that saturated Smurf color I was so hoping for. . . insert pondering poop emoticon here.
PREDICT STUDIES
So WHY, beyond the vibrant excitement of it all, would anyone choose to poop blue? The scientists at Zoe have taken the lead on a nutritional research program called the PREDICT studies, and understanding gut transit time is just one of the measures included in this suite of studies. (You can request the white paper from Zoe at this link) For an overview of the PREDICT program and specifically the PREDICT 1 study, I highly recommend this interview with Dr. Sarah Berry, one of the lead researchers. Zoe’s focus is on personalized nutrition based on your personal gut microbiome. I encourage you to check out their website to delve deeper into their background and the services they provide. But back to poop. . . .
THE BLUE POO PAPER
The original founder of Zoe is Tim Spector, professor of genetic epidemiology at King’s College London, who is one of the authors on the PREDICT 1 study as well as the recently published (February 2021) paper titled:
“Blue Poo: Impact of gut transit time on the gut microbiome using a novel marker.” (1)
The Blue Poo study aimed to assess the relationship between gut-transit time and the gut microbiome, and the efficacy of the blue-dye method as a novel method for measuring gut transit time. Usual measurements for gut transit time are expensive or laborious, so researchers wanted to put the blue-dye method to the test.
In the PREDICT 1 study, results were obtained from 866 participants who consumed and pooped blue muffins. The median (remember, the “median” is the middle number in a list of numbers, and is often thought to be more descriptive than the “average”) gut transit time for this blue-dye method was 28.7 hours, which was in line with previous gut transit time studies. Gut transit times for all participants were divided into four categories (previous research used only three categories of gut transit time):
Fast transit time = less than 14 hours
Normal transit time (1) = 14 to 38 hours (this was the group I landed in!)
Normal transit time (2) = 38 to 58 hours
Slow transit time = greater than 58 hours
The reason there are 2 groups for “normal” transit time rather than 1 is because the researchers noticed a bimodality distribution in the normal gut transit time group. If you think of the peak on a bell curve, this just means there were two peaks, not one, in the range of what is considered “normal” gut transit time - basically, the result showed two separate groups of poopers in this normal time range so they split that group into two, resulting in four groups not three.
An outcome of the Blue Poo study was that “a very strong link exists between the gut microbiome and gut transit time.” (2) And this association is stronger than stool frequency or consistency, meaning that using the blue-dye measurement for gut-transit time will tell you more about your gut microbiome than the consistency or frequency of your poop will.
One of the limitations of the study is that the blue-dye method hasn’t been validated or tested against other transit time methods. Regarding other methods of gut-transit measurement, consider what Dr. Sarah Berry said:
"There are several scientific ways of measuring gut transit time, such as swallowing special capsules or a small wireless device. But these methods are complicated and invasive and can't easily be done at home. Our data shows that transit time, tracked with blue dye, is an indicator of gut health, and is better than other non-invasive methods available.” (3)
I’d be way more willing to eat a couple of blue muffins than to go to a lab or swallow a device. And this is what researchers are banking on - accessible, at-home measurements that can get people enthused about their gut health. Plus, the method was simple, inexpensive, and well-tolerated by the participants; all of which indicate that this measurement tool could be accessible to the general population.
The authors ended the Blue Poo paper by saying this:
“To conclude, our findings indicate that the blue dye method is a novel, inexpensive and scalable method of gut transit assessment providing valuable gut health and metabolic insights. Its wide use in both research and clinical settings could facilitate the advancement of our understanding of gut function and its determinants, as well as the complex interactions between gut physiology and health outcomes.” (4)
So become a citizen scientist today and join the Blue Poop Challenge! After you enter your times and get your results, you’ll also receive practical and informative advice about improving your gut microbiome.
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BUTT. . . Wait. . . here’s a Quick Poop Tip!
Do you have trouble pooping? Many popular methods exist for easing constipation, such as increasing your exercise, fiber, and water intake, but what about. . . perineal massage? That’s right, massaging your perineum (lovingly referred to in the vernacular as “the taint” - more clinically, the skin between your genitals and anus) can ease the difficulty that can accompany pooping
Perineal massage works by breaking up hard stools, relaxing the muscles, and stimulating defecation
A small clinical trial was even conducted to measure the benefits of perineal massage. The resulting paper is titled “Effect of Perineal Self-Acupressure on Constipation: A randomized controlled trial.” (5)
72% in the treatment group reported it helped them “break up, soften, or pass their stools.” (6)
While there were a lot of self-reported limitations with the study, it did show that perineal self-acupressure is a potentially helpful and non-invasive, non-medication treatment for constipation. Here’s to even more trials to come!
I wasn’t enrolled in the study, but I’ve been using this technique for about a year and anecdotally I can tell you it works! Keep in mind, I already get a lot of fiber, water, and exercise, but this manual massage has definitely improved my pooping. While the paper describes perineal massage consisting of “a patient repeatedly applying external pressure to the perineum prior to defecation,” - my personal method is to take two, toilet-paper-covered fingers and gently massage the perineum in circles with firm pressure. Sometimes you can even feel the bowel movement waiting at the gate. The relaxation and stimulation usually gets me pooping within seconds, plus it keeps me in tune with my body.
Don’t be a stranger to yourself, start massaging your taint!
REFERENCES:
(1) Asnicar, Francesco, Emily R Leeming, Eirini Dimidi, Mohsen Mazidi, Paul W Franks, Haya Al Khatib, Ana M Valdes, et al. “Blue Poo: Impact of Gut Transit Time on the Gut Microbiome Using a Novel Marker.” Gut, March 15, 2021, gutjnl-2020-323877. https://doi.org/10.1136/gutjnl-2020-323877.
(2) Ibid
(3) Health, Z. O. E. “ZOE Launches #bluepoopchallenge to Help People Learn About Their Gut Health.” Accessed July 5, 2021. https://www.prnewswire.com/news-releases/zoe-launches-bluepoopchallenge-to-help-people-learn-about-their-gut-health-301293661.html.
(4) Asnicar, Francesco, Emily R Leeming, Eirini Dimidi, Mohsen Mazidi, Paul W Franks, Haya Al Khatib, Ana M Valdes, et al. “Blue Poo: Impact of Gut Transit Time on the Gut Microbiome Using a Novel Marker.” Gut, March 15, 2021, gutjnl-2020-323877. https://doi.org/10.1136/gutjnl-2020-323877.
(5) Abbott, Ryan, Ian Ayres, Ed Hui, and Ka-Kit Hui. “Effect of Perineal Self-Acupressure on Constipation: A Randomized Controlled Trial.” Journal of General Internal Medicine 30, no. 4 (April 1, 2015): 434–39. https://doi.org/10.1007/s11606-014-3084-6.
(6) Ibid